Healthcare Provider Details

I. General information

NPI: 1306314976
Provider Name (Legal Business Name): MR. JAMES PRITCHETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 12/21/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MILLER AVE # 1047
MILL VALLEY CA
94941-1903
US

IV. Provider business mailing address

35 MILLER AVE # 1047
MILL VALLEY CA
94941-1903
US

V. Phone/Fax

Practice location:
  • Phone: 530-205-7946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: